Local Anesthesia

When is it appropriate to bill for local anesthesia; procedures done in office?

you mean the anesthetic itself?

If so, never. If you mean the administration of the anesthetic, then also never. It is part of the procedure, unless you are treating pain and the anesthetic is the reason for the treatment.

local anesthesia for procedures

According to the NCCI edits, local anesthesia for an office procedure is never separately payable. It is included in the payment for the procedure.